In urology

Urology

Urology is the medical and surgical specialty that focuses on the urinary tracts of males and females, and on the reproductive system of males. Medical professionals specializing in the field of urology are called urologists and are trained to diagnose, treat, and manage patients with urological...

, a voiding cystourethrogram (VCUG), also micturating cystourethrogram (MCUG), is a technique for watching a person's urethra

Urethra

In anatomy, the urethra is a tube that connects the urinary bladder to the genitals for the removal of fluids out of the body. In males, the urethra travels through the penis, and carries semen as well as urine...

 and urinary bladder

Urinary bladder

The urinary bladder is the organ that collects urine excreted by the kidneys before disposal by urination. A hollow muscular, and distensible organ, the bladder sits on the pelvic floor...

 while the person urinates (voids). The technique consists of catheter

Catheter

In medicine, a catheter is a tube that can be inserted into a body cavity, duct, or vessel. Catheters thereby allow drainage, administration of fluids or gases, or access by surgical instruments. The process of inserting a catheter is catheterization...

izing the person in order to fill the bladder with a radiocontrast

Radiocontrast

Radiocontrast agents are a type of medical contrast medium used to improve the visibility of internal bodily structures in an X-ray based imaging techniques such as computed tomography or radiography...

 agent, typically cystografin

Diatrizoic acid

Diatrizoic acid , also known as amidotrizoic acid, or 3,5-diacetamido-2,4,6-triiodobenzoic acid, is a radiocontrast agent containing iodine. Trade names include Hypaque, Gastrografin and Urografin, the latter being a combination of the sodium and meglumine salts.Diatrizoate is considered a...

. Under fluoroscopy

Fluoroscopy

Fluoroscopy is an imaging technique commonly used by physicians to obtain real-time moving images of the internal structures of a patient through the use of a fluoroscope. In its simplest form, a fluoroscope consists of an X-ray source and fluorescent screen between which a patient is placed...

 (real time x-rays) the radiologist watches the contrast enter the bladder and looks at the anatomy of the patient. If the contrast moves into the ureter

Ureter

In human anatomy, the ureters are muscular tubes that propel urine from the kidneys to the urinary bladder. In the adult, the ureters are usually long and ~3-4 mm in diameter....

s and back into the kidney

Kidney

The kidneys, organs with several functions, serve essential regulatory roles in most animals, including vertebrates and some invertebrates. They are essential in the urinary system and also serve homeostatic functions such as the regulation of electrolytes, maintenance of acid–base balance, and...

s, the radiologist makes the diagnosis of vesicoureteral reflux

Vesicoureteral reflux

Vesicoureteral reflux is an abnormal movement of urine from the bladder into ureters or kidneys. Urine normally travels from the kidneys via the ureters to the bladder...

, and gives the degree of severity a score. The exam ends when the person voids while the radiologist is watching under fluoroscopy. Consumption of fluid promotes excretion of contrast media after the procedure. It is important to watch the contrast during voiding, because this is when the bladder has the most pressure, and it is most likely this is when reflux will occur.

Vesicoureteral reflux

Vesicoureteral reflux

Vesicoureteral reflux is an abnormal movement of urine from the bladder into ureters or kidneys. Urine normally travels from the kidneys via the ureters to the bladder...

 (kidney reflux) is diagnosed with an ultrasound and VCUG. Children who have chronic urinary tract infection

Urinary tract infection

A urinary tract infection is a bacterial infection that affects any part of the urinary tract. Symptoms include frequent feeling and/or need to urinate, pain during urination, and cloudy urine. The main causal agent is Escherichia coli...

s are given this test to determine the level of damage to the kidney.

Indications

• All boys presenting with recurrent UTI or abnormality on ultrasound if first UTIurinary tract infections
• Girls < 3 years of age with their first UTI
• Girls < 5 years of age with febrile UTIs
• Older girls with pyelonephritis
  Pyelonephritis
  Pyelonephritis is an ascending urinary tract infection that has reached the pyelum or pelvis of the kidney. It is a form of nephritis that is also referred to as pyelitis...
  
   or recurrent UTIs
• Suspected obstruction (e.g. bilateral hydronephrosis
  Hydronephrosis
  Hydronephrosis is distension and dilation of the renal pelvis calyces, usually caused by obstruction of the free flow of urine from the kidney, leading to progressive atrophy of the kidney...
  
  )
• Suspected bladder trauma or rupture
• Stress incontinence (urine)

Contraindications

• Untreated urinary tract infection
• Hypersensitivity to contrast media
• Fever within the past 24 hours

External links

• Voiding cystourethrogram - National Library of Medicine
• What is a voiding cystourethrogram? - radiologyinfo.org